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Home My WebLink About22171-z TOWN OF SOUTHOLD BUILDING DEPARTMENT office cf the Building Inspector Town Hall $outhold, N.Y. ~ERTIFICATE OF OCCUPANCY No Z-23127 Date JULY 28, 1994 THIS CERTIFIES that the building ADDITION Location of Property 300 PRIVATE ROAD ~12 ORIENT, NY House No. Street Hamlet County Tax Map No. 1000 Section 15 Block 8 Lot 25 Subdivision Filed Map NO. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated J~NE 22, 1994 pursuant to which Building Permit No. 22171-Z dated JULY 7, 1994 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is AN ATTA~D DECK TO EXISTING DWELLING AS APPLIED FOR. The certificate is issued to ANNE CHRISTINE NENDEL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A l~ing Inspector Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HAU. SOU/HOLD, N.Y. No BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ................. ................. 22171 Z Building Inspector. _ Rev. 6/30/80 Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOIl CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, prop&rty lihes, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings , and installations, a certificate of Code Compliance from architect or engineer · responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B.· For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy r New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ Date .................................... New Construction .......... Old Or Pre-existing,Building ........ Location of Property.i ~ ~/~ House No. Street Hamlet Onwer or Owners of Property .... /,zy./~..~.....~.~.~,:~!4./~.~. ~-~.~..~L County Tax Map No 1000, Section .... iS-.~ ..... Block ................ Lot ..... ~.~ ............. Subdivision .................................... Filed Map ............ Lot ...................... Permit No...~..~...~.~..~.Date Of Permit .... 7.q~..~...~.Applicant....~.~..~.....~.~//..~. ..... saltb De t. ' - ' ' p ~pprova± .... ~ ....... /~j .......... Underwriters Approval .... ~./ ................ Planning Board Approval ..... ~ ............ Request for: Temporary Certificate ........... Final Certicate.......~.... Fee Submitted: $.~,.~.'....--~. .................. .......... ............ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ,~INAL REMARKS: _ ~ DATE ~///,~'/?,~ INSPECTOR 76s.18o~ - I ~ BUILDING DEPT. .~~ INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] I~SULATION I' ] FRAMING ~ FINAL REMARKS: ~)~ DATE "~/~'~ J~ J INSPECTO~~.~ FOUI___iDA._TIO__.~ -- L~_(! s t ) (2nd) STATE ENERG~ CODE FI;;AL '. . /, TIO~IA'L COM~IE~'ITS: R & R HOME IMPROVEMENT & BUILDING INC. P.O. Box 676 GREENPORT, NEW YORK 11944 (516) 477-1255 JOB SHEET NO. CALCULATED BY CHECKED BY OF DATE EO~/ QF C~I~C. POST~ '/ o. ' CIEDAF( I~,~,~_CH 'LANE FORM NO. 1 TOWN OF SOUTHOI' D BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... BOAED OF ,.- .... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEI~TIC FORH .............. hOT ~py , CALL ................... MAIL TO: TOWN OF SOUTHOLD I INSTRUCTIONS a. This application mu~t be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or tareas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apph- cation· · c..The work covered by this application may not be commenced before issuance of Building Permit. · t d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work· e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, fof, ltl;i~F~0~i~st~¢tjt)f~ of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees, to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit, authorized-insp'~t'0rs on'premises find in building for necessary inspqctions: . % ~ '' ' r' (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent,, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~ .~..Ix;?_~.,...Q..~..x7 .Qh~.~.b.e....~.. C..~q..~..~.~-, .............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· ·. C .../.. ............. · (Name and ti'tlc of corporate officer · ) Builder's License No .... I..~.~.~..1 .... .~..~.... ..... Plumber's License No ..... .k57.~. .............. Electrician's License No ....~././~· .......... :... Other Trade's License No .....kJ~. ............. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No, 1000 Section / ~ Block ~' Lot....c~..~... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) ". · 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .E-. ' a. Existing use and Occupancy .... }. .... .~. Y%.. ................... ' b. Intended use and occupancy .~ .~..~ .¢,?. ~' .L.~:,. ,. 3. Nature ofwork (check which a~plicable): NewBuflding .......... Addition~.....~-~.. Alteration .......... Repair .............. Removal .............. Demolition ............. Other Work .............. ' "' (Description) 4. Estimated Cost.. ~., ~.~.~. t~,' ~ · · / ....... ....................... Fee ...................................... i (to be paid on filing this application) 5. If dwelling, number of dwelling hnits .............. Number of dwelling units on each floor ...... If garage, number of cars ... [ ......... 6. If business, co.mmercial or mixe~ oceupa}lcy, ~pecify nature and ext'en~ of'eac~l type';f 7. Dimensions of existing structurels' if any: Front ............... Rear .............. Depth ............. Height ............... Number of Stories ..................................................... ' Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth .................... I' · Hei.gt~rt ...................... Number of Stories .............. ~ .... 8. Dimensions of entire new construction Front n~,~ ,,*Jgm ....... r~um'ber of Stodes 9 Size of lot: Front" Rear Depth 10' Date of Purch.ase .......... i ..................................................... ............ blame of Former Owner I 1. Zoneor use dmtrict in which pr~mises are situated ~ [2.. D.o. es proposed constructio~vi~¢te any zoning law, ordinance or regulation: .$).Q ....... : ....... '~*'~' ~';'4" ''~ .... 13. Will lot be regraded ....... /.~ ....... ..: ·. ~. ......Will excess fill be removed from pr0~S~i~O~¢,v. ~,~w No Name of Architect ~"~/~.., Addr Name °f C°ntract°r · · f'/'2' · 0.,· j. · .q' ........... Address P-.~: ~?-g ~ 7 ge .~' PT: Phon.e No ~'7 7.7 ~ ~. ~ .'~... 15. Is this property within 300 feet of a tidal wetlahd? *~'af..'...'.'.',' ~o~..... :..' ..... · If yes, Southold ~own Trustees Permit may be required. PLOT DIAGRAM ' Locate clearly and distinctly all !buildings, wh~ther existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. APPROVED AS NOTED., / N~IF~ BUILDING DEP~MENT AT 765;1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: ~. FOtJNDATK)~,~ 'B~O REQUIRED FOR PO U [:~ ~: 2. ROUG~ ~' 'Y: '~. 4 PLUMBING THE' RE:~UIH[:~,%NTS OF THE NY, STATE CONR'{T~U(:TION g, ~NERGY C(')O~$ ~K)'f PFL~PONSIBLE FOR STATE OF NEJkV'5~R~.~ _ . .~ S.S COUNTY QF_ .'~"~"'~ .... ~ ....... ...... (Name dTindividdal signifig contract) above named. ! .......... being duly sworn, deposes and says that he is the applicant He is the ~ ...~-'~.. . ' . ~ontr~agent, corporgte [2fficer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contai:~ed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ;et forth in the application filed therewith· Sworn to before me this ....... ~. ...... day of .... . .N,~...~, a~-. ......., 19 .~.y~ ~ ~ ~ ~g~o~ Y~3 ' / ' (Signature of applic~t) ., T~rmE~iresO~o~r31,1 / ~